What question did this study set out to answer?

This study aims to analyze trends in cardiac arrest related to hypertension and project future mortality rates in U.S. adults.

May 26, 2026Open Access

Temporal Trends and Forecasted Cardiac Arrest and Hypertension-Related Mortality in U.S. Adults, 2000–2035: A Nationwide CDC WONDER Multiple Cause-of-Death Study

Key Points

This study aims to analyze trends in cardiac arrest related to hypertension and project future mortality rates in U.S. adults.
Retrospective analysis of Multiple Cause-of-Death data from the CDC WONDER database (2000-2024).
Calculated age-adjusted mortality rates and used joinpoint regression for annual percent changes.
Projected mortality rates through 2035 using Auto-ARIMA and Prophet models in R.
1,693,840 deaths from cardiac arrest with concurrent hypertension were recorded from 2000 to 2024.
Age-adjusted mortality rates increased from 24.56 to 31.68 with an annual average percent change of 0.82 (p < 0.000001).
Higher mortality rates were observed among men, NH Black/African American adults, and older adults (≥ 65 years).

Abstract

Abstract Background Cardiac arrest (CA) occurring in the setting of hypertension (HTN) represents a critical and under-recognized intersection of acute cardiovascular catastrophe and chronic vascular disease in the United States (U.S.). The coexistence of sudden cardiac dysfunction and long-standing HTN may amplify morbidity and mortality and contribute to persistent demographic and geographic disparities. This study characterizes 2000–2024 national trends in CA with concurrent HTN among U.S. adults and projects age-adjusted mortality rates (AAMRs) through 2035. Methods We conducted a retrospective analysis of Multiple Cause-of-Death data from the CDC WONDER database for CA with HTN mortality among adults aged ≥ 25 years (2000–2024). We calculated AAMRs and used joinpoint regression to estimate annual percent changes (APCs) and the average APC (AAPC) with 95% confidence intervals (CIs). We projected AAMRs through 2035 using Auto-ARIMA and Prophet time-series models in R (v4.5.0) and evaluated model performance using the root mean squared error (RMSE). Results From 2000 to 2024, there were 1,693,840 deaths from CA with concurrent HTN. Overall AAMR rose from 24.56 to 31.68, with an AAPC of 0.82 ( p < 0.000001). Men had higher AAMRs than women (overall AAMR: men 32.89; women 25.95). Among races, non-Hispanic (NH) Black/African American adults had the highest mortality (AAMR: 58.25). Older adults (≥ 65 years) bore the highest burden (AAMR: 122.60). Geographic differences were observed, with the West having the highest burden (AAMR: 43.75). Urban areas had higher AAMRs than rural areas (28.88 vs. 25.50). Most deaths (43.78%) occurred in medical facilities. Forecasting to 2035 indicates continued rises, particularly among men, NH Black/African American adults, older adults, West and rural areas. Conclusion CA with concurrent HTN imposes a substantial and rising mortality burden, with pronounced demographic and geographic disparities. Continued surveillance and targeted public-health interventions are warranted.

Bookmark

View Full Paper